The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain: A Prospective Open-label Study
Abstract
Objectives: The objective of this prospective, open-label study was to determine the long-term effect of medicinal cannabis treatment on pain and functional outcomes in participants with treatment-resistant chronic pain. Patients and Methods: The primary outcome was the change in the pain symptom score on the S-TOPS (Treatment Outcomes in Pain Survey—Short Form) questionnaire at the 6-month follow-up in an intent-to-treat population. Secondary outcomes included the change in S-TOPS physical, social, and emotional disability scales, the pain severity, and pain interference on the Brief Pain Inventory, sleep problems, and the change in opioid consumption. Results: A total of 274 participants were approved for treatment; complete baseline data were available for 206 (intent-to-treat), and complete follow-up data for 176 participants. At follow-up, the pain symptom score improved from median 83.3 (95% confidence interval [CI], 79.2-87.5) to 75.0 (95% CI, 70.8-79.2) ( P <0.001). The pain severity score (7.50 [95% CI, 6.75-7.75] to 6.25 [95% CI, 5.75-6.75]) and the pain interference score (8.14 [95% CI, 7.28-8.43] to 6.71 [95% CI, 6.14-7.14]) improved (both P <0.001), together with most social and emotional disability scores. Opioid consumption at follow-up decreased by 44% ( P <0.001). Serious adverse effects led to treatment discontinuation in 2 participants. Discussion: The treatment of chronic pain with medicinal cannabis in this open-label, prospective cohort resulted in improved pain and functional outcomes, and a significant reduction in opioid use. Results suggest long-term benefit of cannabis treatment in this group of patients, but the study’s noncontrolled nature should be considered when extrapolating the results.
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Opioid sparing, or the reduction of opioid use, resulting from the use of CBM for pain management was the primary outcome in one study and a secondary outcome in six studies.
“Opioid sparing, or the reduction of opioid use, resulting from the use of CBM for pain management was the primary outcome in one study86 and a secondary outcome in six studies.69,73,81,84,87,91”
From Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions (2024) · cites this paper as [73]
Three studies found positive associations between medical cannabis use and opioid sparing.
“Three studies found positive associations between medical cannabis use and opioid sparing.69,73,102”
From Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions (2024) · cites this paper as [73]
Two observational studies found 44-64% reductions in self-reported opioid consumption in cohorts of patients with chronic pain who were using cannabis.
“Two studies found 44-64% reductions in self-reported opioid consumption in cohorts of patients with chronic pain who were using cannabis (Boehnke et al, 2016;Haroutounian et al, 2016).”
From Opioid-Sparing Effect of Cannabinoids: A Systematic Review and Meta-Analysis (2017) · cites this paper as Haroutounian et al, 2016
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- Authors
- Haroutounian, S., Ratz, Y., Ginosar, Y., Furmanov, K., Saifi, F., Meidan, R., & Davidson, E.
- Affiliations
- Washington University in St. Louis (US)
- Pain Relief Unit
- Hadassah Medical Center (IL)
- Hebrew University of Jerusalem (IL)
- Corresponding author
- Haroutounian, Simon
- Ratz, Yael
- Saifi, Fayez
- Meidan, Ronit
- Davidson, Elyad
- Venue
- The Clinical Journal of Pain
- Published
- 2016-12
- Volume
- 32
- Issue
- 12
- Pages
- 1036-1043
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2281864230
- Cited by
- 234
- References
- 69
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 21 · 2023: 20 · 2022: 29 · 2021: 34 · 2020: 36 · 2019: 22 · 2018: 29 · 2017: 19 · 2016: 2
- FWCI
- 19.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- medical cannabis, chronic pain, treatment-resistant pain, quality of life, disability, pain intensity, pain interference, opioid consumption, sleep disorders, long-term outcomes, adverse effects
- MeSH terms
- Analgesics, Disability Evaluation, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Pain Measurement, Prospective Studies, Surveys and Questionnaires, Sleep, Treatment Outcome, Chronic Pain, Pain Management, Medical Marijuana
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